Endometriosis, while commonly managed by gynecologists, is rarely encountered by general surgeons and is often identified incidentally or upon histopathological examination. This condition can manifest in both pelvic and extrapelvic sites, with extrapelvic endometriosis most frequently observed in the gastrointestinal tract and abdominal wall. Cesarean scar endometriosis (CSE) is the most prevalent form of abdominal wall endometriosis. Cyclical symptoms linked to menstruation occur in around half of patients and should raise suspicion in cases presenting with scar-related or subcutaneous swellings. This report presents two cases of extrapelvic endometriosis: one involving appendiceal endometriosis, which was unexpectedly identified as appendicitis, and another with CSE, diagnosed after surgical excision of a painful swelling in the cesarean section scar. The discussion focuses on the diagnosis and management of CSE and appendiceal endometriosis.
Sivagnanam et al. (Sat,) studied this question.